PATIENT ENQUIRY

The Water-soluble Vitamins

The Water-soluble Vitamins

VITAMIN B-COMPLEX FAMILY

The B-Complex vitamins compromise several water soluble vitamins: Thiamine (B1); Riboflavin (B2); Niacin (B3); Pantothenic acid (B5); Pyridoxine (B6); Biotin (B7); Folic acid (B9) and Cobalamin (B12).

The B complex vitamins usually coexist in nature in unprocessed foods. They are readily excreted via the kidneys and so cannot be stored in the body. They have a low toxicity profile and must be consumed on a daily basis.

THIAMINE (B1)

Thiamine plays a central role in the generation of energy from carbohydrates. It is involved in RNA and DNA production, as well as nerve function. Its active form is a coenzyme called Thiamine pyrophosphate (TPP), which takes part in the conversion of pyruvate to acetyl Coenzyme A (CoA) in metabolism, and thus regulates energy production from carbohydrate and protein fuel sources.

Thiamine Deficiency:

Vitamin B1 absorption may be impaired with malnutrition, chronic intestinal disease and chronic alcohol ingestion.  Absorptioon may also be impaired in people with Type II diabetes and HIV/AIDS and can also be compromised by consumption of raw fish which is rich in the enzyme thiaminase.

Vitamin B1 deficiency can result in Beriberi with heart failure, brain cell damage and cognitive dysfunction.

It manifests as the following clinical signs and symptoms:

Apathy, confusion, emotional lability, depression, fatigue, insomnia, irritability, nervousness, headache, memory-loss, muscle weakness, increased pain-sensitivity, numbness/burning in the hands or feet, increased sound-sensitivity, indigestion, loss of appetite, constipation, sluggish metabolism, palpitations, shortness of breath and heart-failure.

Supplemental Dosage:
Require 1 mg/day: Increased need with high sugar/alcohol intake.

Natural Sources:
Wheat germ, rice bran, yeast, bran, lean pork, liver, poultry, egg-yolk, fish, legumes such as dried-beans and peas.

Therapeutic Dosage:
100 – 200 mg per day : Injections may be required if problems with impaired digestion or intestinal absorption are present.

Signs of Toxicity:
Anaphylactic shock has occurred with injections. Dizziness, palpitations, flushing, itching, hives and angio-oedema have all been reported after high-dose thiamine treatment.

RIBOFLAVIN (B2)

Vitamin B2 is converted in the body into active co-factors called FAD and FMN.  These co-factors are essential in energy production, particularly in the Citric Acid Cycle which is the major energy production cycle in the cell fuel factories.  Vitamin B2 is also essential to amino-acid synthesis and activation of other B group vitamins.

Riboflavin Deficiency:

Vitamin B2 deficiency may occur as a result of intestinal disease with malabsorption, inadequate diet (e.g., famine), chronic high alcohol intake and various medication.  Reduced absorption may result from coeliac disease, lactose intolerance, food allergy, intestinal bacterial overgrowth and malignant disease.  Vitamin B2 deficiency is usually associated with other B vitamin deficiencies and is not uncommonly found in pregnant and lactating women, people of advanced age and/or low socioeconomic status, and patient with depression or anorexia.

Riboflavin deficiency results in reduced energy production and reduced protein synthesis.  It commonly manifests with the following clinical symptoms and signs:

Insomnia, dizziness and depression, light-sensitivity, red-itchy-burning eyes, blurred vision, cataracts, magenta-hued tongue, cheilosis (Cracks/soreness in corners of mouth), oily/scaly skin (especially around mouth and nose), dyssebacea (whiteheads and and blackheads), acne, excessive hair loss.

Supplemental Dosage:
Require 1 mg/day : A higher dose may be required if Vit B6 is being taken in high doses.

Natural Sources:
Milk, cheese, liver, organ meats, yeast, lean meat and breads.

Therapeutic Dosage:
Up to 500 mg/day have been prescribed without side effects.

Signs of Toxicity:
There are no known toxicity effects.

NIACIN (B3)

Vitamin B3 occurs in two different forms; nicotinic acid and niacinamide, both of which are converted into the active coenzymes NAD and NADP.  NAD serves as a hydrogen and electron carrier in the Citric Acid Cycle and the mitochondrial electron transport chain, which generates the energy storage molecule ATP.  NADP also functions as a hydrogen and electron carrier in energy production and also is essential in the synthesis of fatty acids, cholesterol, steroid hormones and DNA.  It is also essential to regeneration of vitamin C and glutathione, two of the major tissue antioxidants.

Vitamin B3 is easily absorbed in the small intestine, but absorption can be compromised as the result of inadequate diet, chronic high alcohol intake, intestinal disease with malabsorption and a variety of medications.

Vitamin B3 deficiency:

Vitamin B3 deficiency is called Pellagra and manifests as diarrhoea, dermatitis, dementia and finally death, if not detected and corrected in the early stages.  Niacin inadequacy compromises gastric acid production and impairs energy production, particularly affecting digestive, cardiovascular and brain function.

Deficiency may manifest with the following clinical symptoms and signs:

Fearful feelings, anxiety, excessive worry, suspiciousness, feelings of gloom, depression, fatigue, irritability, insomnia, muscle tension/soreness, headaches, anorexia/nausea, abdominal discomfort/pain, flatulence/wind, bloating, halitosis, diarrhoea, muscle weakness, burning sensation in tongue & limbs, sensory dysperception, dementia, cognitive disorders, strawberry-tip tongue, white-coated tongue, mid-line cracks in tongue, dental-indentations at tongue margins, sore mouth, swollen/painful gums, dermatitis (localised scaly pigmented rash).

Some patients with schizophrenia respond well to Niacin therapy.

Supplemental Dosage:
Require up to 20 mg/day : Stress increases requirements.

Natural Sources:
Lean meats, poultry, fish, peanuts, brewer’s yeast, liver and wheat germ.

Therapeutic Dosage:
100 – 10,000 mg used in schizophrenia and also to lower cholesterol.

Signs of Toxicity:
Flushing-burning sensation (Niacin), mental-confusion, depression, elevated uric acid, liver-damage, photodermatitis.

PANTOTHENIC ACID (Calcium Pantothenate – B5)

Vitamin B5 is present in a wide variety of foods, both animal and vegetable, usually in its cofactor forms, Coenzyme A and Acyl carrier protein (ACP).  In the intestine these cofactors are converted into vitamin B5, which after absorption is then reconverted back into CoA and ACP.  These cofactors are essential in the energy production from carbohydrates, proteins and fats, and in synthesis of fatty acids, cholesterol and acetylcholine (the major brain neurochemical).

Pantothenic Acid is well absorbed in the small intestine via an energy consuming active transport system.  However, vitamin B5 absorption may be compromised due to inadequate food consumption (e.g., famine and poverty), intestinal disease with malabsorption and diabetes.

Vitamin B5 deficiency:

Vitamin B5 deficiency usually co-exists with other B group deficiencies and may manifest with the following signs and symptoms:

Fatigue, exhaustion, depression, adrenal-exhaustion, anorexia, nausea/vomiting, abdominal bloating/discomfort, constipation burning feet, numbness/tingling in hands/feet, aching mid-back, impaired coordination, low blood pressure, Low blood sugar, recurrent infection, excessive hair-loss.

Supplemental Dosage:
Require up to 20 mg/day: Increased with pregnancy, stress, allergy and chronic illness.

Rich Natural Sources:
Eggs, kidney, salmon, sardines, liver, yeast and natural foods.

Therapeutic Dosage:
500 to 2000 mg/day.

Signs of Toxicity:
No known toxicity effects.

PYRIDOXINE (B6)

Vitamin B6 occurs in food as three related molecules, pyridoxine, pyridoxal and pyridoxamine, each of which is bound to a phosphate molecule (phosphorylated) in their natural state.  These B6 vitamers are broken down in the intestine to release free Vitamin B6, which can then be absorbed.  Following absorption, all three forms of vitamin B6 are converted into pyridoxal-5-phosphate, the active coenzyme form of vitamin B6.  Absorption may be impaired due to inadequate diet, high alcohol intake, intestinal disease with malabsorption and a variety of medications.  Vitamin B6 conversion into its active coenzyme form may be impaired by high oestrogen levels, high alcohol intake, medications, and lack of vitamin B2, magnesium of zinc.

Pyridoxal-5-phosphate almost always works together with zinc, and this pairing is essential to amino acid metabolism and protein synthesis, as well as production of energy and inflammatory chemicals called prostaglandins. As such, vitamin B6 insufficiency impacts upon immune system, cardiovascular and brain cell function.

Adequate vitamin B6 is vital to the healthy development and function of the nervous system. It is involved in the manufacture of several neurotransmitters including serotonin, GABA, dopamine and noradrenaline, and plays an important role in regulating mental processes and mood. Vit B6 Concentrations are up to 25 to 50 times higher in the brain than in the blood.

Vitamin B6 deficiency:

Vitamin B6 deficiency may manifest with the following clinical signs and symptoms:

Nervousness, agitation, anxiety, emotional-upset, mood swings, irritability, insomnia, depression, fatigue, poor dream-recall fluid-retention, premenstrual-tension, low blood sugar, low blood pressure, dizziness, acne (especially post-adolescence), facial oiliness dandruff, hair-loss, cheilosis (cracks in mouth corners) sore tongue, anorexia and nausea, anaemia, numbness/tingling in hands/feet, impaired wound healing, arthritis (especially in finger/toe joints).

Supplemental Dosage:
Require up to 2 mg/day: increased with pregnancy, ageing, illness, stress and hormone therapy. Increased requirement with isoniazid and other drugs.

Rich Natural Sources:
Meats (especially organ meats), fish, whole wheat, breads, soybean, avocados, peanuts, walnuts, fresh fruit (especially bananas).

Therapeutic Dosage:
100 to 1000 mg/day : toxicity reactions above 2000 mg/day.

Signs of Toxicity:
Sensory neuropathy (numbness in hands/feet).

FOLATE (Folacin, Folic Acid) ~ (B9)

Folate is a B complex vitamin that occurs naturally in many foods, particularly leafy, green vegetables and is well absorbed from the intestine.  Once absorbed it is converted into a complex molecule, called tetrahydrofolate (THF), which is the biologically active form.  The conversion of folate into THF is dependent upon vitamin B12 activity, which if impaired can result in depleted THF status, despite apparently normal folate blood levels.

Along with vitamin B12, the active THF molecule is essential in the process of methylation, wherein methyl groups (CH3) are transferred from one molecule to another.  This process is essential to the protection and repair of both DNA and RNA, neurotransmitter and homocysteine metabolism, which are necessary for normal brain cell function and blood vessel integrity.   Folate is also essential for synthesis of DNA, particularly during rapid cell division and growth and for red cell production in the bone marrow.  Thus, good folate activity is vital to promote and maintain normal health and function in all body tissues and organs.  Several other forms of folate are also produced in the body and these function in specific and well defined metabolic pathways.

Folate is generally well absorbed from the small intestine but this can be compromised by bacterial overgrowth in the small intestine, food allergies and intestinal disease.  Within the body, folate activity may be impaired due to vitamin B12 deficiency, whilst in about 30% of the population, a genetic defect in the enzyme MTHFR also impairs folate activation.  This defective gene is particularly important in pregnant women as even mild reduction in folate activity can interefere with foetal growth and development.

Folate deficiency:

Folate deficiency may manifest clinically with the following signs and symptoms:

Mental sluggishness, poor memory and concentration, apathy, fatigue, depression, paranoid-thinking, cheilosis, sore-red tongue, anorexia, poor digestion, constipation, shortness of breath, irritability, insomnia, restless legs.

Folic acid deficiency in pregnancy is associated with foetal neural tube defects (Spina Bifida).

Supplemental Dosage:
Require 40 micrograms/day : Up to 5mg in pregnancy and lactation.

Rich Natural Sources:
Leafy, green vegetables.

Therapeutic Dosage:
2 to 20 mg daily.

Signs of Toxicity:
Overexcitability – leading to excess euphoria (mania), increased mental instability, irritability, restless sleep, vivid dreaming, abdominal distension, anorexia, flatulence, nausea, malaise.

NOTE: high dose supplement may worsen epilepsy control.

COBALAMIN (B12)

Vitamin B12 is an essential micronutrient required for red cell production, neuro-cognitive and cardiovascular function. It is essential to methylation processes (the transfer of methyl molecules), which is essential to nerve cell fatty acid synthesis, neutralisation of the toxic metabolite homocysteine detoxification and protection & repair of DNA.

The principal source of vitamin B12 is from animal protein. The preliminary step in the metabolism of vitamin B12 involves its release from animal sources, a process mediated by the action of pepsin and gastric acid. After the release, dietary vitamin B12 binds to the R-protein secreted by the salivary glands. In the duodenum, in the presence of an alkaline medium and pancreatic proteases, the R- protein is hydrolysed to release vitamin B12 which later binds with the intrinsic factor (IF) secreted by the gastric parietal cells. The vitamin B12 –IF complex is highly resistant to proteolytic degradation and travels through the intestine to attach at its specific receptor site in the mucosa of the terminal ileum, where absorption occurs.

Vitamin B12 absorption may be impaired with high alcohol intake, and intestinal disease such as chronic atrophic gastritis (mainly in the elderly), pernicious anemia, celiac disease, chronic pancreatitis. B12 absorption may also be compromised by drugs such as metformin and proton pump inhibitors (PPIs). Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with diabetes mellitus, ,however, the commonest cause of Vit B12 deficiency is poor dietary intake, as occurs in vegetarians and chronic alcoholism.

Vitamin B12 deficiency:

Vitamin B12 deficiency may manifest clinically with the following signs and symptoms:

Impaired memory, poor concentration, impaired learning, fatigue, depression, mood swings, mental illness leading to hallucinations, confusion, paranoia, psychosis, dizziness, numbness/tingling in hands/feet, unsteady gait and/or balance, red-sore-smooth tongue, poor digestion, abdominal discomfort.

If uncorrected, Vitamin B12 deficiency can result in spinal cord degeneration, megaloblastic anaemia and bone marrow failure.

Supplemental Dosage:
Require approximately 3-4 micrograms daily.

Rich Natural Sources:
Liver, kidney, muscle-meats, poultry, fish, eggs, dairy produce.

Therapeutic Dosage:
Hydroxycobalamin 1000 micrograms by injection 1-2 times/week.  Up to 5000 ugm every 2 days in Chronic Fatigue Syndrome.

Signs of Toxicity:
No toxicity reactions known.

BIOTIN

Once referred to as vitamin H, Biotin is an often overlooked member of the B complex vitamins.  It is an essential nutrient cofactor in four specific carboxylase enzymes that are required for glucose and fatty acid metabolism.

Biotin is widely distributed in many foods and is also produced by friendly bacteria in the colon.  It is absorbed in the upper half of the small intestine, though Biotin availability varies across a wide range of foods, e.g., 100% bio-availability in corn and 0% bio-availability in wheat.  Dietary Biotin can be irreversibly bound by avidin, a protein present in raw egg white.

Biotin deficiency:

Biotin deficiency has been associated with the following signs and symptoms:

Drowsiness, lassitude, apathy, depression, anorexia, nausea, muscle pains, excessive sensitivity to touch, skin rash (flaking, itchiness, grey-toned skin), anaemia, high cholesterol, hair-loss, pale-smooth tongue.

Supplemental Dosage:
Require approximately 300 ugm/day.  Supplementation is usually unnecessary unless eating raw egg white which contains the protein Avidin which destroys biotin.

Rich Natural Sources:
Egg yolk, organ meats, yeast, legumes and nuts.

Signs of toxicity:
No known toxic reactions.

CHOLINE

Choline is not classed as a vitamin, as it is synthesized by the liver.  However, it is commonly associated with the B complex vitamins and is present in many plant and animal foods, usually as lecithin complex, along with inositol, Choline  is well absorbed from the intestine and transported to the liver, where it is utilised to synthesize bile salts, which are necessary for fat digestion and cholesterol excretion.

Choline is also converted into phospholipid molecules (phosphatidylcholine) that are essential to the formation of cell membranes and nerve fibres. It is also the substrate for acetylcholine synthesis, the major neurotransmitter in the brain, peripheral nerves and muscles cells).

Choline depletion:

In many people, particularly with aging, choline production may be impaired and may manifest clinically with the following signs and symptoms:

Poor fat digestion, nausea/squeamish with fatty-foods, gallstones, gastric ulcers, fatty infiltration of liver (kidney and Liver damage in rats), impaired memory and concentration, high blood pressure.

Supplemental Dosage:
1 Tblspn lecithin :  Also requires methionine, B12 and Folate.

Rich Natural Sources:
Lecithin, egg yolk, brewer’s yeast, fish, soybeans, peanuts, beef liver and wheat germ.

Therapeutic Dosage:
Up to 10 – 16 g/day : to treat Tardive Dyskinesia and Alzheimer’s disease – phosphotidyl-choline is preferable.

Signs of Toxicity:
No known toxicity reactions.

INOSITOL

Initially considered to be a minor member of the B-complex vitamin family, Inositol (myoinositol) is now known to be produced in the human body from glucose, and hence is not now classified as an essential nutrient or vitamin.

Inositol, along with choline, occurs naturally as highly bioavailable phophatidyl lipid molecules in plant and animal lecithin and as biologically unavailable phytic acid (inositol hexaphosphate) in vegetables, nuts and grains. Dietary phytic acid binds irreversibly to minerals, such as iron, calcium, zinc and manganese, and high grain & nut consumption may significantly interfere with mineral absorption.

Myoinositol and its phospholipid metabolites are essential to liver fat metabolism and cell membrane health and integrity, particularly the cells of the nervous system, bone marrow, eyes and heart muscle. Inositol and its phosphorylated metabolites also function as intracellular signalling molecules, involved in the cell response to insulin, calcium control, maintenance of cell membrane electrical activity and cytoskeletal structure. Recent genetic studies show that inositol and its metabolites also function to regulate gene expression and DNA & RNA activity within the cell.

People with significant depression reportedly have reduced spinal fluid inositol and inositol therapy has been show to alleviate depression and panic attacks. Inositol therapy is reported to promotes strong, healthy hair growth, reduce blood lipid levels and reduce blood vessel arteriosclerosis.

Inositol depletion:

Low inositol status may occur due to intestinal disease with malabsorption or impaired inositol synthesis and may manifest clinically with the following signs and symptoms:

Excessive hair loss, constipation, eczema, high-cholesterol levels, lethargy, depression, panic attacks and impaired cognitive function.

People with diabetes have an unduly high inositol loss in the urine and this can contribute to the peripheral nerve damage associated with diabetes.

Supplemental Dosage:
500 mg/day.

Rich Natural Sources:
Lecithin, beef, brain, heart, wheat germ, Bulgar rice, brown rice molasses, brewer’s yeast, nuts, citrus fruit.

Therapeutic Dosage:
Up to 12 g daily of myoinositol

Signs of Toxicity:
No known toxic reactions.

VITAMIN C (ASCORBIC ACID)

Vitamin C is a water soluble compound initially identified as the nutritional factor that prevents scurvy. It is synthesised from glucose and other simple sugars by almost all animals and plants. However, humans and other primates have a mutated non-functional gene that codes for the enzyme required in the final step of ascorbic synthesis, and are thus unable to synthesise Vitamin C. A similar gene mutation is also found in guinea pigs, fruit bats, and a few select species of fish and birds.

Vitamin C is a strong reducing agent (antioxidant) that interacts with other antioxidant molecules, to maintain glutathione cycling, regenerate Vitamin E and stabilise folic acid.  Ascorbate is an important co-factor in several enzymes that are involved in collagen production, noradrenaline and adrenaline synthesis, peptide hormone and tyrosine metabolism and carnitine biosynthesis, which is essential to mitochondrial fuel metabolism.  Ascorbic acid is found in high concentrations in gastric juices, where it facilitates absorption of various minerals, particularly iron and calcium, and reportedly serves to neutralise food derived, cancer-promoting N-nitroso chemicals.

In recent years, gene studies have shown that Vitamin C is a significant cell signalling molecule that interacts with several cellular transcription factors thereby modulating gene expression and promoting cell growth and differentiation.

Contemporary studies over the past few years have shown high-dose intravenous ascorbate therapy (up to 75gm IV 2-3 times a week) exhibits significant beneficial effects in cancer therapy, alleviating adverse effects and improving beneficial effects from chemotherapy, improving patient vitality and morbidity and promoting cancer regression in some cases.

Vitamin C deficiency:

Vitamin C deficiency traditionally results in clinical scurvy if left untreated. However, chronic subclinical Vit C depletion reportedly affects white blood cell activity, immune system function and energy production and may manifest clinically as following symptoms and signs.

Subclinical depletion:

Fatigue , Mood Changes (irritability or short tempered), Weight Loss , Joint and Muscle Aches, Bruising, Periodontal disease and bleeding gums, Dry Hair and Skin, Frequent infections

Acute Scurvy:

Sallow or muddy complexion, loss of vigour, lassitude, easily tired, impaired exercise tolerance, breathlessness, loss of appetite, anaemia, easy bruising, fleeting pains in joints and limbs (especially in legs).

Sore gums, congested and spongey gums, bleeding gums, spontaneous bleeding, petechiae and ecchymoses in skin, haemorrhages around hair follicles (especially on thighs), bruised and swollen eyelids, blood in urine.

Severe Late-stage Scurvy:

Dingy and brown complexion, spongey and bleeding gums, pyorrhoea, halitosis, loss of teeth, atrophy and dissolution of jawbone, severe weakness, palpitations and dyspnoea with mild exertion, poor wound healing, skin atrophy, dissolution of old wounds, brittle bones, osteopenia, impaired immunity: severe infections, pneumonia and sudden collapse and death, mental symptoms(at all stages, facial expression usually haggard, frowning and ‘pained’, with careworn knitted brow.

Supplemental Dosage:
1000 to 2000 mg daily (RDA: 30-40 mg/day).  If a smoker – minimum of 2 g (2000 mg) daily.

Rich Natural Sources:
Citrus fruit, green vegetables, tomatoes, berries, peppers, cauliflower, broccoli, parsley.

Therapeutic Dosage:
Acute viral illness (colds, flu etc) – up to 16 gm/day.  Sudden stress (infections, wounds, burns etc) – up to 16 gm/day.  Higher doses up to ‘bowel tolerance’ may be used by practitioners.

Signs of Toxicity:
Bowel irritability with flatulence and diarrhoea, increased urinary oxalate excretion with loin pain and kidney-stone formation, possible increased aluminium absorption, sudden stoppage of Vit C supplements may cause rebound scurvy.

BIOFLAVONOIDS (VITAMIN P COMPLEX)

Bioflavonoids are fat-soluble, complex pigmented molecules synthesised by plants for flower colouration, ultraviolet filtration and chemical signalling molecules. The major bioflavonoids are quercetin, diosmin, hesperidin, rutin and naringin, whilst related flavonol molecules are called catechins.

These plant nureints are not essential to life but, with regular consumption, exhibit a wide variety of long-term health benefits, including cardiovascular disease and cancer prevention.  They have strong antioxidant activity in the laboratory though there is significant doubt that they express antioxidant activity in the body. However, the flavonoids and catechins do demonstrate significant activity in other metabolic processes and are reported to:

inhibit coagulation, thrombus formation or platelet aggregation

reduce risk of atherosclerosis

reduce arterial blood pressure and risk of hypertension

reduce vascular inflammatory mechanisms

improve endothelial and capillary function

regulate carbohydrate and glucose metabolism

modify blood lipid levels

modify mechanisms of aging

Flavonoids reportedly enhance Vit C-related connective tissue synthesis and improve capillary permeability and integrity.

In Europe, bioflavonoids and related substances are often used in the treatment of blood vessel disease (hemorrhoids , chronic venous insufficiency , leg ulcers, easy bruising) and  lymphatic congestion after breast cancer surgery

Bioflavonoids have been found to act as potent anti-inflammatory agents, and modulators of prostaglandin metabolism.  As such, they are therapeutically useful for:  traumatic swelling, bruising and pain and other inflammatory conditions such as arthritis and asthma,.

Foods with a high flavonoid content include parsley, onions, blueberries and other berries, black tea, green tea and oolong tea, bananas, all citrus fruits, Ginkgo biloba, red wine, and dark chocolate (with a cocoa content of 70% or greater)

Bioflavonoid deficiency:
There is no specific deficiency state described for bioflavonoids status though recurrent easy bruising and venous disorders may be indications for flavonoid therapy.

Rich Natural Sources:
Citrus fruit, apricots, cherries, grapes, green peppers, tomato, papaya, cantaloupe, broccoli.
Other foods with a high flavonoid and/or catechin content include parsley, onions, blueberries and other berries, black tea, green tea and oolong tea, bananas, all citrus fruits, Ginkgo biloba, red wine, and dark chocolate (with a cocoa content of 70% or greater)

Therapeutic Usage:
Quercetain & other flavonols ~ 1000 – 3000mg daily
Catechins ~ 50 – 200mg daily

Signs of Toxicity:
Nausea, itching and rash in flavone-sensitive persons.

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